Summaries of health policy coverage from major news organizations

Investigation: Medical Errors Plague Assisted-Living Facilities

Medical errors are prevalent at assisted-living facilities across California, and many facilities that have been fined for such problems have remained in operation without paying the penalties, according to an investigation by U-T San Diego.

The investigation was conducted in partnership with the California HealthCare Foundation's Center for Health Reporting. CHCF publishes California Healthline.

Details of Investigation

For the investigation, U-T San Diego acquired 7,000 state records of assisted-living center inspections and examined them for medical errors.

Problems discovered at assisted-living facilities included:

Employees being discouraged from reporting medical mistakes;

Failure to schedule medical appointments for residents when ordered by a doctor;

Housing residents who needed a higher level of care than staff could provide;

Facilities House Sicker Patients

Consumer groups say the state in recent years has allowed sicker patients to be housed at assisted-living facilities without increasing staff training requirements.

For example, the facilities are allowed to house residents with:

Catheters;

Colostomy bags;

Deep bedsores;

Serious communicable infections;

Staph infections;

Tracheotomies; and

Other conditions.

According to the investigation, assisted-living centers are not required to employ medically trained staff to deal with such conditions (Schoch, U-T San Diego, 12/14).

In addition, the investigation found that many workers at assisted-living facilities did not primarily speak English, which can limit communication with residents.

Investigators noted that the California Department of Social Services -- which licenses and regulates assisted-living centers -- does not track medical errors at the facilities.

Furthermore, the state has no way to track trending or systemic mistakes at such facilities, according to officials (McDonald, U-T San Diego, 12/14).

Few Fines Collected

The investigation also found that only half of the $2.9 million in fines levied against assisted-living facilities since July 2007 has been collected by the state.

Meanwhile, hundreds of facilities that have unpaid fines remain licensed and continue to operate (McDonald/Clark, U-T San Diego, 12/14).

U-T San Diego reports that there is no penalty for late payments and that the maximum fine for an assisted-living facility is $150, compared with $100,000 for nursing homes (AP/Sacramento Bee, 12/15).

State Sen. Leland Yee (D-San Francisco) has called for a hearing in response to the investigation (McDonald/Clark, U-T San Diego, 12/14).

DSS' Response

In response to the investigation, DSS officials defended the agency's oversight of assisted-living facilities.

Michael Weston, deputy director of DSS, said the department is "extremely vigilant" about ensuring that assisted-living employees undergo 16 hours of required training and pass a written exam to become licensed (McDonald, U-T San Diego, 12/14).

DSS said it is taking steps to ensure that fines for violations are collected but noted that:

A pilot project to privatize collections has stalled; and

A recommendation to impose late fees still requires legislative action (McDonald/Clark, U-T San Diego, 12/14).

This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.